Innovation is Academic

Fecal Microbiota Transplantation

Innovative treatment fights dangerous infection

Though intended to be curative or even lifesaving, antibiotics can sometimes introduce a health threat. One is clostridium difficile (C. difficile), an aggressive intestinal bacteria that can cause a serious to dangerous infection. This occurs when antibiotic treatment clears the colon of the healthy bacteria that normally reside there and keep C. difficile at bay.

About C. difficile

C. difficile is a common bacterial infection and can be aggressive. It infects about 500,000 people in the United States every year and sends hundreds of thousands to the hospital. C. difficile can be fatal, causing 14,000 to 30,000 deaths annually.

Organisms normally present in the GI tract generally occupy the sites where C. difficile would attach and grow. When antibiotics wipe out helpful bacteria, C. difficile can take hold. When those who carry C. difficile fail to wash their hands well, they contaminate surfaces they touch. When others touch contaminated surfaces, they may inadvertently transfer the bacteria to their food or mouths.

Symptoms and risks

The symptoms of C. difficile include:

Watery diarrhea three or more times a day for more than two days

Abdominal pain

Mild to moderate nausea

Loss of appetite

In more serious cases, inflammation within the colon can be extensive, even cause bleeding and damage to the intestinal lining. Symptoms of severe infections include:

Watery diarrhea as often as 15 times daily

Severe abdominal pain and intestinal cramping

Dehydration

Fever

Weight loss

Very severe cases can lead to dehydration, low blood pressure, kidney failure or bowel perforation.

Antibiotic use is the primary trigger of a C. difficile infection, especially when used for a long period of time or when a broad-spectrum antibiotic that kills a wide variety of bacteria has been prescribed.

Weakened immune system due to chemotherapy, immunosuppression drugs or AIDS

Previous C. difficile infection, especially recent

If you develop diarrhea within a few days of admission to or release from the hospital or within two months of taking an antibiotic or have three or more bouts of diarrhea in 24 hours, C. difficile could be responsible.

Diagnosis and treatment

There are several ways to diagnose and treat C. difficile.

The infection can be diagnosed by:

Stool test or blood test

Endoscopic examination

CT scan

Treatment options include:

Antibiotics. If you are already taking an antibiotic, your doctor may switch to a different one. Metronidazole, vancomycin and fidaxomicin are often chosen to combat stubborn C. difficile.

Probiotics. These living microorganisms, including bacteria and yeasts, are similar to those that naturally inhabit the GI tract and can help fight C. difficile by competing for the space it occupies.

Surgery. In severe cases, a surgeon may need to remove the infected or damaged part of the GI tract.

Fecal microbiota transplantation (FMT). This is a procedure in which stool from a healthy donor is transferred into the colon of the patient with C. difficile. The healthy stool brings with it the healthy microorganisms lacking in the patient's GI tract.

How does FMT work?

The human body is home to a microbiome, a living community of bacterial organisms that play important roles in processes such as nutrition and immunology.

In FMT, the bacterial community of a healthy donor is placed into the patient with C. difficile. The donor and sample are carefully screened. The healthy stool is transferred to the recipient through the upper GI tract (via prepared capsule or tube from the nostrils to the intestine) or the lower GI tract (via colonoscopy, sigmoidoscopy or enema).

Why choose us

As a national leader in academic medicine, we provide comprehensive care for even the most complex conditions. Our physicians, nurses and staff share a commitment to service, continuous improvement and patient care excellence.

For the 11th year in a row, U.S. News & World Report has ranked The University of Kansas Hospital among the nation's best. We are among a select few in the country to be ranked in 8 medical and surgical specialties, including gastroenterology and GI.

These distinctions – based on reputation and patient outcomes data – helped lead to our being named the Best Hospital in Kansas City and the Best Hospital in Kansas.